Effects on Alcohol Use and Anxiety of the September 11, 2001, Attacks and Chronic Work Stressors: A Longitudinal Cohort Study

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Abstract
Objectives. We hypothesized that chronic stressors associated with an everyday social role (work) would interact with a traumatic macrosocial stressor (the terrorist attacks of September 11, 2001) in predicting mental health status (during the fall of 2001). Methods. We used mail surveys returned as part of wave 3 of a workplace cohort study, both before and after September 11, 2001, to assess decision latitude, sexual harassment, generalized workplace abuse, psychological distress, and alcohol use. We also used regression analyses to assess the main effect of September 11 and interactions between September 11 and stressors, after control for baseline mental health. Results. The main effect of September 11 on elevated alcohol use was significant for women but not for men. For women, work stressors significantly interacted with experiencing the events of September 11 to affect alcohol use and anxiety outcomes. Conclusions. Women experiencing chronic work stressors were most vulnerable to elevated psychological distress and alcohol use after September 11, 2001.